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NPI 1417050956

NPI 1417050956 : REGENTS OF THE UNIVERSITY OF CALIFORNIA : SAN DIEGO, CA

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General NPI Number Information
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    NPI Number           |    1417050956
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    Entity Type          |    Organization 
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    Legal Business Name  |    REGENTS OF THE UNIVERSITY OF CALIFORNIA 
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Dates
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    Enumeration Date     |    09/07/2006
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    Last Update Date     |    04/01/2024
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Provider Practice Location Address
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    Address Line         |    200 W ARBOR DR 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92103-9000
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    Country              |    US
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    Telephone            |    800-926-8273
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    Fax                  |    888-539-8781
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Provider Business Mailing Address
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    Address Line         |    PO BOX 232410 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92193-2410
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DIRECTOR REVENUE CYCLE & OPERATIONS
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    Name                 |     MICHAEL DENNIS PRICE 
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    Credential           |    
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    Telephone            |    858-249-6752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2085B0100X
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    Taxonomy Name        |    Body Imaging Physician
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    2085U0001X
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    Taxonomy Name        |    Diagnostic Ultrasound Physician
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    2085R0202X
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    Taxonomy Name        |    Diagnostic Radiology Physician
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    License Number       |    
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    License Number State |    
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